García Zahid, Preciado Rodríguez Juan Martín, Portillo Abril Gloria Elena, Contreras Paniagua Alma Delia, Ortega-Vélez María Isabel
Departament of Public Nutrition and Health, Centro de Investigación en Alimentación y Desarrollo (CIAD), Hermosillo, Sonora, Mexico.
Department of Industrial Engineering, University of Sonora, Hermosillo, Sonora, Mexico.
Front Public Health. 2025 Jun 4;13:1482256. doi: 10.3389/fpubh.2025.1482256. eCollection 2025.
Obesity is a growing global public health problem and a risk factor for developing non-communicable diseases (NCDs). The food environment is crucial in shaping nutritional behaviors and health outcomes. However, how food environment indicators interrelate and impact the population's health in middle- and low-income countries is unclear. This study examined the association between the food environment and indicators of obesity and NCDs in adult women from medium and high-marginalization areas in Hermosillo, Northwest Mexico.
A randomized sample of 104 adult women and 80 food retail stores participated in this cross-sectional study. Data on diet, anthropometric measurements, and NCD diagnoses were collected. We assessed the food environment's personal (perceived) and external (measured) dimensions. Personal dimensions included perceived accessibility, affordability, convenience, and desirability of foods, while external dimensions comprised the variety, prices, density of food establishments, and advertising presence in participants' neighborhoods. Data were collected via questionnaires and inventories and analyzed using geospatial and structural equation modeling (SEM) techniques to explore the relationships between food environment indicators and health outcomes.
The participants, with an average age of 47.6 years, exhibited an average BMI of 31.0 kg/m, a high prevalence of abdominal obesity (90%), and NCDs (40%). The food environment in these areas was characterized by a high density and variety of food establishments offering unhealthy food options. Participants also perceived prices of healthy foods as high and reported exposure to advertising promoting unhealthy foods. Structural equation modeling revealed that a more nutritious food environment, as indicated by the perception of availability and lower prices of healthy foods, was negatively associated with waist circumference (: -0.37, < 0.05) and indirectly with the prevalence of NCDs (: 0.30, < 0.05).
Our findings contribute to the empirical evidence that food environments influence the nutritional health of vulnerable populations. The results suggest that public policies should focus on improving the food environment by enhancing the availability and affordability of healthy foods.
肥胖是一个日益严重的全球公共卫生问题，也是引发非传染性疾病（NCDs）的一个风险因素。食物环境对于塑造营养行为和健康结果至关重要。然而，在中低收入国家，食物环境指标如何相互关联并影响民众健康尚不清楚。本研究调查了墨西哥西北部埃莫西约中高边缘化地区成年女性的食物环境与肥胖及非传染性疾病指标之间的关联。
104名成年女性和80家食品零售店的随机样本参与了这项横断面研究。收集了饮食、人体测量数据和非传染性疾病诊断数据。我们评估了食物环境的个人（感知）维度和外部（实测）维度。个人维度包括对食物的可及性、可负担性、便利性和吸引力的感知，而外部维度包括参与者社区内食品企业的种类、价格、密度以及广告情况。通过问卷调查和清单收集数据，并使用地理空间和结构方程模型（SEM）技术进行分析，以探究食物环境指标与健康结果之间的关系。
参与者平均年龄为47.6岁，平均体重指数为31.0kg/m，腹型肥胖患病率高（90%），非传染性疾病患病率为40%。这些地区的食物环境特点是提供不健康食品选择的食品企业密度高且种类多。参与者还认为健康食品价格高，并表示接触到宣传不健康食品的广告。结构方程模型显示，如对健康食品的可得性和较低价格的感知所示，更具营养的食物环境与腰围呈负相关（β：-0.37，P<0.05），并与非传染性疾病患病率呈间接负相关（β：0.30，P<0.05）。
我们的研究结果为食物环境影响弱势群体营养健康这一实证证据提供了补充。结果表明，公共政策应通过提高健康食品的可得性和可负担性来专注于改善食物环境。
